Physical Therapy Commons^™

Can Foot Exercises Alter Foot Posture, Strength, And Walking Foot Pressure Patterns In People With Severe Flat Foot?, Jeff Houck, Lacey Seidl, Austin Montgomery, Joshua Keefer, Miranda Walker

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Muscle training muscle control for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Although studies demonstrated improvement in foot posture (validated foot posture index [FPI]) immediately following a 4-week exercise program this was not assessed in people with flatfoot. Also, more rigorous assessment of foot function is lacking (i.e. foot posture, strength, and plantar pressure during walking). There is clearly a need for more rigorous clinical data on the effect of foot exercises. The purpose of this pilot study was to assess the immediate effect of …

Clinical Utilization Of Patient Reported Outcome (Promis) Scores For Surgical Reconstruction Of Posterior Tibialis Tendon Dysfunction, Michael Anderson, Jeff Houck, Adolph Flemister, Judith Baumhauer, John Ketz, Benedict Digiovanni, David Ciufo, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Previous studies have demonstrated that preoperative Patient Reported Outcome Instrumentation System (PROMIS) scores effectively predict improvement in foot and ankle surgery. Adult acquired flatfoot deformity (AAFD) and Posterior Tibialis Tendon Dysfunction (PTTD) are a common surgical problem, but it is unclear if the specific thresholds for the physical function (PF), pain interference (PI) and depression published previously for all foot and ankle surgeries apply to a specific diagnosis. Furthermore, the interplay of PROMIS scores and clinical variables has not been evaluated. The purpose of this study was: 1) to investigate the change in PROMIS scales and radiographic measurements from …

The Road To Recovery For Bunion Surgery: Data Analytic Plots To Target Patient Progress, Ashlee Macdonald, Jeff Houck, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patient reported outcomes (PROs) can provide information on individual patient’s progress throughout a treatment course and additionally, with common surgeries, powerful numbers can be generated to provide data analytic curves to provide a recovery road map for patients and surgeons. Those who deviate negatively from the predicted path may have a complication and early intervention can be initiated. Those who deviate positively have the potential to need less physical therapy, early return to sports or work. Hallux valgus (HV) is a common condition of the foot with 4.4 million patients seeking care yearly and surgery is equally common. The …

Preseason Jump And Hop Measures In Male Collegiate Basketball Players: An Epidemiologic Report, Jason Brumitt, Amy Engilis, Dale Isaak, Amy Briggs, Alma Mattocks

Faculty Publications - College of Physical Therapy

Background: Injuries are inherent in basketball with lower extremity (LE) injury rates reported as high as 11.6 per 1000 athletic exposures (AEs); many of these injuries result in time loss from sport participation. A recent trend in sports medicine research has been the attempt to identify athletes who may be at risk for injury based on measures of preseason fitness.

Hypothesis/Purpose: The purpose of this prospective cohort study was to determine if the standing long jump (SLJ) and/or the single-leg hop (SLH) for distance functional performance tests (FPT) are associated with non-contact time loss lower quadrant (LQ, defined as lower …

Spine Biomechanics Associated With The Shortened, Modern One-Plane Golf Swing, R. Barry Dale, Jason Brumitt

Faculty Publications - College of Physical Therapy

The purpose of this study was to compare kinetic, kinematic, and performance variables associated with full and shortened modern backswings in a skilled group of modern swing (one-plane) golfers. Shortening the modern golf backswing is proposed to reduce vertebral spine stress, but supporting evidence is lacking and performance implications are unknown. Thirteen male golfers performed ten swings of each swing type using their own 7-iron club. Biomechanical-dependent variables included the X-Factor kinematic data and spine kinetics. Performance-related dependent variables included club head velocity (CHV), shot distance, and accuracy (distance from the target line). Data were analysed with repeated measures …

Risk Factors Associated With Noncontact Time-Loss Lower-Quadrant Injury In Male Collegiate Soccer Players, Jason Brumitt, Amy Engilis, Amber Eubanks, Alma Mattocks, Jennifer Peet, Nathanael Bush

Faculty Publications - College of Physical Therapy

Introduction: The incidence of time-loss injury in male collegiate soccer players in the United States (US) is 6.4 per 1000 athletic exposures. With thousands of male athletes competing in soccer at the US collegiate level each year, there is the potential for numerous time-loss injuries that may ultimately impact team success. Thus, identifying risk factors for injury is warranted.

Purpose: The primary purpose of this study was to determine if preseason functional performance test (FPT) measures (the standing long jump [SLJ] and single-leg hop [SLH] for distance tests) were associated with an increased risk of a noncontact time-loss lower-quadrant (LQ) …

Functional Performance Deficits Exist In Female Naia Collegiate Athletes With History Of Anterior Cruciate Ligament Reconstruction, Jason Brumitt, Amy Engilis

Faculty Publications - College of Physical Therapy

This study compared preseason measures of standing long jump (SLJ) and single-leg hop (SLH) distances between female collegiate athletes with or without history of anterior cruciate ligament reconstruction (ACLR). The data from 45 female collegiate athletes (mean age: 20.6 +- 2.2 years) competing at the National Association of Intercollegiate Athletes (NAIA) level in three team sports (volleyball, soccer, and basketball) were collected as a subanalysis of measures for a prospective cohort study. There were no differences in SLJ or SLH distances between athletes with or without prior history of low back and/or lower extremity sports injuries. However, female athletes with …

The Lower-Extremity Functional Test And Lower-Quadrant Injury In Ncaa Division Iii Athletes: A Descriptive And Epidemiologic Report, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul Niemuth, Alma Mattocks, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Context: The Lower-Extremity Functional Test (LEFT) has been used to assess readiness to return to sport after a lower extremity injury. Current recommendations suggest that women should complete the LEFT in 135 s (average; range 120-150 s) and men should complete the test in 100 s (average; range 90-125 s). However, these estimates are based on limited data and may not be reflective of college athletes. Thus, additional assessment, including normative data, of the LEFT in sport populations is warranted. Objective: To examine LEFT times based on descriptive information and off-season training habits in NCAA Division III (Dill) athletes. In …

Current Concepts Of Muscle And Tendon Adaptation To Strength And Conditioning, Jason Brumitt, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Injuries to the muscle and/or associated tendon(s) are common clinical entities treated by sports physical therapists and other rehabilitation professionals. Therapeutic exercise is a primary treatment modality for muscle and/or tendon injuries; however, the therapeutic exercise strategies should not be applied in a “one-size-fits-all approach”. To optimize an athlete’s rehabilitation or performance, one must be able to construct resistance training programs accounting for the type of injury, the stage of healing, the functional and architectural requirements for the muscle and tendon, and the long-term goals for that patient. The purpose of this clinical commentary is to review the muscular and …

Utility Of Ultrasound For Imaging Osteophytes In Patients With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Peter C. Chimenti, Mark R. Buckley, Jeff R. Houck, A. Samuel Fleminster

Faculty Publications - College of Physical Therapy

Objectives: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT).

Design: Case-control study.

Setting: Academic medical center.

Participants: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40).

Interventions: Not applicable.

Main Outcome Measures: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using …

Functional Performance Deficits Exist In Female Naia Collegiate Athletes With History Of Anterior Cruciate Ligament Reconstruction, Jason Brumitt

Faculty Publications - College of Physical Therapy

No abstract provided.

Randomized Controlled Trial Comparing Orthosis Augmented By Either Stretching Or Stretching And Strengthening For Stage Ii Tibialis Posterior Tendon Dysfunction, Jeff Houck, Christopher Neville, Josh Tome, Adolph Flemister

Faculty Publications - College of Physical Therapy

Background: The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD).

Methods: Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching …

The Lower Extreminty Functional Test: Normative And Epidemiological Data In A Collegiate Female Athlete Population, Jason Brumitt, Bryan Heiderscheit, Robert C. Manske, Paul E. Niemuth, A. Mattocks

Faculty Publications - College of Physical Therapy

No abstract provided.

Training Toys ... Bells, Ropes, And Balls - Oh My!, Dixie Stanforth, Jason Brumitt, Nicholas Ratamess, Whitney Atkins, Steven J. Keteyian

Faculty Publications - College of Physical Therapy

Participation in regular moderate-to-vigorous physical activity often decreases with increasing age (16), and among people who do exercise, long-term adherence often is a challenge because of various factors including lack of enjoyment, intrinsic motivation, or social support; poor environment; inconvenience; fear of injury; and health-related issues. During the past decade, general fitness professionals and personal trainers have incorporated numerous adjunct modalities (‘‘toys’’) to ‘‘break up’’ the rigors of fitness training and as a means to introduce some diversion and goal-specific activities. Three popular modalities are kettlebells, battling ropes, and medicine balls. This article briefly reviews each device and presents some …

Weight-Bearing Asymmetry In Individuals Post-Hip Fracture During The Sit To Stand Task, Janet A. Kneiss, Tiffany N. Hilton, Josh Tome, Jeff R. Houck

Faculty Publications - College of Physical Therapy

Background: Individuals post hip fracture decrease force on the involved limb during sit to stand tasks, creating an asymmetry in vertical ground reaction force. Joint specific differences that underlie asymmetry of the vertical ground reaction force are unknown. The purpose of this study was to compare differences in vertical ground reaction force variables and joint kinetics at the hip and knee in participants post-hip fracture, who were recently discharged from home care physical therapy to controls.

Methods: Forty-four community-dwelling older adults, 29 who had a hip fracture and 15 elderly control participant’s completed the sit to stand task on an …

Off-Season Training Habits And Preseason Functional Test Measures Of Division Iii Collegiate Athletes: A Descriptive Report, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Neimuth, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Purpose/Background: Division III (D III) collegiate coaches are challenged to assess athletic readiness and condition their athletes during the preseason. However, there are few reports on off-season training habits and normative data of functional assessment tests among D III athletes. The purpose of this study was to examine off-season training habits of D III athletes and their relationships to the standing long jump (SLJ) and single-leg hop (SLH) tests.

Methods: One-hundred and ninety-three athletes (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 y) were tested prior to the start of their sports seasons. Athletes reported …

Adult-Acquired Flatfoot Deformity And Age-Related Differences In Foot And Ankle Kinematics During The Single-Limb Heel-Rise Test, Ruth L. Chimenti, Joshua Tome, Cody D. Hillin, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

STUDY DESIGN: Cross-sectional laboratory study.

OBJECTIVE: To compare single-limb heel-rise performance and foot-ankle kinematics between persons with stage 2 adult-acquired flatfoot deformity (AAFD) and healthy controls.

BACKGROUND: The inability to perform a single-limb heel rise is considered a positive functional diagnostic test for AAFD. However, which foot motions contribute to poor performance of this task are not known.

METHODS: Fifty individuals participated in this study, 20 with stage 2 AAFD (mean +/- SD age, 57.6 +/- 11.3 years), and 15 older participants (age, 56.8 +/- 5.3 years) and 15 younger participants (age, 22.2 +/- 2.4 years) without AAFD as control …

Altered Tendon Characteristics And Mechanical Properties Associated With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Adolph S. Flemister, Joshua Tome, James M. Mcmahon, Marie A. Flannery, Ying Xue, Jeff R. Houck

Faculty Publications - College of Physical Therapy

Study Design: Case-control laboratory study.

Objectives: To compare tendon characteristics (shape, composition) and mechanical properties (strain, stiffness) on the involved side of participants with insertional Achilles tendinopathy (IAT) to the uninvolved side and to controls, and to examine if severity of tendon pathology is associated with severity of symptoms during function.

Background: Despite the severity and chronicity of IAT, the quality of theoretical evidence available to guide the development of exercise interventions is low. While tendon pathology of midportion Achilles tendinopathy has been described, there are few studies specific to IAT.

Methods: Twenty individuals with unilateral IAT and 20 age- …

Lower Extremity Functional Tests And Risk Of Injury In Division Iii Collegiate Athletes, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Niemuth, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Purpose/Background: Functional tests have been used primarily to assess an athlete’s fitness or readiness to return to sport. The purpose of this prospective cohort study was to determine the ability of the standing long jump (SLJ) test, the single-leg hop (SLH) for distance test, and the lower extremity functional test (LEFT) as preseason screening tools to identify collegiate athletes who may be at increased risk for a time-loss sports-related low back or lower extremity injury.

Methods: A total of 193 Division III athletes from 15 university teams (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 …

Clinical Outcomes And Static And Dynamic Assessment Of Foot Posture After Lateral Column Lengthening Procedure, Heather Barske, Ruth Chimenti, Josh Tome, Elizabeth Martin, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Lateral column lengthening (LCL) has been shown to radiographically restore the medial longitudinal arch. However, the impact of LCL on foot function during gait has not been reported using validated clinical outcomes and gait analysis.

Methods: Thirteen patients with a stage II flatfoot who had undergone unilateral LCL surgery and 13 matched control subjects completed self-reported pain and functional scales as well as a clinical examination. A custom force transducer was used to establish the maximum passive range of motion of first metatarsal dorsiflexion at 40 N of force. Foot kinematic data were collected during gait using 3-dimensional motion …

Core Stabilization Exercise Prescription, Part 2: A Systematic Review Of Motor Control And General (Global) Exercise Rehabilitation Approaches For Patients With Low Back Pain, Jason Brumitt, J. W. Matheson, Erik P. Meira

Faculty Publications - College of Physical Therapy

Context: Therapeutic exercises are frequently prescribed to patients with low back pain. Numerous exercise programs for patients with low back pain have been described. Many of these treatment programs are based on 1 of 2 popular rehabilitation strategies: a motor control exercise approach or a general exercise approach.

Data Sources: PubMed clinical queries from 1966 to March 2013 for keyword combinations including motor control exercise, core stability exercise, therapeutic exercise, general exercise, global exercise, local exercise, transversus abdominis, segmental stabilization, and low back pain.

Study Selection: Randomized controlled trials that assessed the effects of a motor control exercise approach, a …

Abstract: Functional Testing And Prediction Of Lower Extremity Or Low Back Injury Among Division Iii Collegiate Athletes, Jason Brumitt

Faculty Publications - College of Physical Therapy

No abstract provided.

Core Stabilization Exercise Prescription, Part I: Current Concepts In Assessment And Intervention, Jason Brumitt, J. W. Matheson, Erik P. Meira

Faculty Publications - College of Physical Therapy

Context: Injury to the low back can cause significant pain and dysfunction, which can affect an athlete’s performance and result in time lost from sport. A common conservative treatment is therapeutic core stabilization exercises, which can address pain and musculoskeletal dysfunction in patients with low back pathology.

Evidence Acquisition: MEDLINE and CINAHL were searched (from 1966 to March 2013) to identify relevant research. Keywords and keyword combinations searched included motor control exercise, segmental stabilization, core stabilization, transversus abdominis, multifidi, and low back pain.

Results: There are 2 popular rehabilitation strategies to assess core function and promote core stabilization. Each has …

Total And Distributed Plantar Loading In Subjects With Stage Ii Tibialis Posterior Tendon Dysfunction During Terminal Stance, Christopher Neville, A. Samuel Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: In subjects with stage II tibialis posterior tendon dysfunction (TPTD), the function of the tibialis posterior muscle is altered and may be associated with a change in total and distributed loading.

Methods: Thirty subjects with a diagnosis of stage II TPTD and 15 matched control subjects volunteered to participate in a study to examine the total and distributed plantar loading under the foot during the terminal stance phase of gait. Plantar loading, measured as the subject walked barefoot, was assessed using instrumented flexible insoles. A secondary analysis was done to explore the contribution of flatfoot kinematics to plantar loading …

Influence Of Upper Extremity Assistance On Lower Extremity Force Application Symmetry In Individuals Post–Hip Fracture During The Sit-To-Stand Task, Janet A. Kneiss, Jeff R. Houck, Susan A. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

STUDY DESIGN: Controlled laboratory study using a cross-sectional design.

OBJECTIVES: To compare lower extremity force applications during a sit-to-stand (STS) task with and without upper extremity assistance in older individuals post–hip fracture to those of age matched controls.

BACKGROUND: A recent study documented the dependence on upper extremity assistance and the uninvolved lower limb during an STS task in individuals post–hip fracture. This study extends this work by examining the effect of upper extremity assistance on symmetry of lower extremity force applications.

METHODS: Twenty-eight community-dwelling elderly subjects, 14 who had recovered from a hip fracture and 14 controls, participated in …

A Systematic Review Of Sensorimotor Function During Adolescence: A Developmental Stage Of Increased Motor Awkwardness?, Catherine C. Quatman-Yates, Carmen Quatman, Andrew Mezsaros, Mark V. Paterno, Timothy E. Hewett

Faculty Publications - College of Physical Therapy

No abstract provided.

Comprehensive Strength Training Program For A Recreational Senior Golfer 11-Months After A Rotator Cuff Repair, Jason Brumitt, Erik P. Meira, Hui En Gilpin, Meredith Brunette

Faculty Publications - College of Physical Therapy

Background and Purpose: Golf is a popular sport played by hundreds of thousands of individuals of all ages and of varying skill levels. An orthopedic or sports-related injury and/or surgery may limit an individual’s sport participation, require him/her to complete a course of rehabilitation, and initiate (or resume) a sportspecific training program. Unlike the availability of evidence to guide postsurgical rehabilitation and sportspecific training of athletes from sports other than golf, there have only been two reports describing outcomes after surgery and for golfers. The purpose of this case report is to present a post-rehabilitation return to sporttraining program for …

Analysis Of Vertical Ground Reaction Force Variables During A Sit To Stand Task In Participants Recovering From A Hip Fracture, Jeff R. Houck, Janet Kneiss, Susan V. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

Background: A Sit to Stand task following a hip fracture may be achieved through compensations (e.g. bilateral arms and uninvolved lower extremity), not restoration of movement strategies of the involved lower extremity. The primary purpose was to compare upper and lower extremity movement strategies using the vertical ground reaction force during a Sit to Stand task in participants recovering from a hip fracture to control participants. The secondary purpose was to evaluate the correlation between vertical ground reaction force variables and validated functional measures.

Methods: Twenty eight community dwelling older adults, 14 who had a hip fracture and 14 control …

Patellofemoral Pain Syndrome Alters Neuromuscular Control And Kinetics During Stair Ambulation, Naoko Aminaka, Brian G. Pietrosimone, Charles W. Armstrong, Andrew Mezsaros, Phillip A. Gribble

Faculty Publications - College of Physical Therapy

The aim of the study was to investigate differences in frontal plane knee kinetics, onset timing and dura-tion of the gluteus medius (GMed), adductor longus (AL), and vastus medialis oblique (VMO) during stair ambulation between those with and without patellofemoral pain syndrome (PFPS). Twenty PFPS patients and twenty healthy participants completed stair ambulation while surface electromyography (EMG), video, and ground reaction forces were collected. PFPS patients had a higher peak internal knee abduction moment during stair ascent, and a higher internal knee abduction impulse for both ascent and descent. During stair ascent, PFPS patients displayed earlier onset of the AL …

Musculoskeletal Healthcare For Latino Migrant Farmworkers: Interprofessional Collaboration To Provide Service And Educate Future Health Care Providers, Jason Brumitt, Leda Garside, Rebecca Reisch, Talina Marshall, Hu En Gilpin, Jessica Kinsey, Kelsey Imondi

Faculty Publications - College of Physical Therapy

The inability to access health care services is a significant issue in the United States (US). The US Census Bureau reports that as of 2009 over 50 million individuals (16.7% of the population) lacked health insurance. The number of people who became uninsured has also increased over time. One segment of the US population that is particularly vulnerable to health care inequities is Latinos. Failure to access timely primary medical services may increase the risk of disease transmission, morbidity, and mortality. In addition, failing to address health care needs at the primary provider level may contribute to an overutilization of …